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Question about placement of TENS electrodes.

BrihtwulfBBrihtwulf Posts: 69
edited 06/11/2012 - 8:31 AM in Chronic Pain
So, I was finally given my TENS unit today (after some confusion with the insurance company). After my instructions and also reading up a great deal on their use, there seem to be a number of ways to place the electrodes. What I would like to get is an opinion on optimal use of the unit with my condition.

I have lower back pain in the area of my L5-S1. Had a previous discectomy there and I have narrowing in both lateral foramina and some edema in the area as well. The majority of the pain is centered very slightly to the right side of my spine, right at that joint.

I read about the "surround the area" method by placing the electrodes around the center of the pain. I've tried this so far, and though I know results can take a while, I didn't seem to notice much from it. I also read about placing the electrodes directly on top of the pain site or slightly above (between the source of the pain and your brain).

Does anyone have recommendations as far as what might be the best placement for my type of back pain, or things best avoided? I would like to get off on the right foot as much as possible...



  • dilaurodilauro ConnecticutPosts: 9,842
    I have had the best luck placing the pads on other side of the area I wanted to take care of. Since I have Lumbar, Thoracic and Cervical disc problems, I have placed those Pads up and down my spine.
    In the beginning, I didnt get much out of the Tens unit. As I started to use it more and gradually turned up the frequency I started to get relief.
    My Tens unit is a bit unique in that it was purchased in Japan and is all in Japanese , so I have had to test out the different buttons and dials to get the best results. Sometimes, I almost jumped out of my seat. But now I have it done pretty good
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • as most of you know i swear by TENS and over the years i have spent far too much on various new technology i have settled on the acticare it is the BMW of the TENS world .any way you are wanting to know about electrode placement ..yes?? if you have lower back pain say L4/L5 for instance place the electrodes just below you kidneys on both side {even though you have right sided pain like i do ]also select the fast throb throb mode on your unit .this is about the best mode for chronic pain .the tap tap tap mode is not much good for this .do not use a TENS directly on your spine .as far as i know there is only one device {acticare that has modes suitable for direct spine use this is called TES mode .replacement electrodes can be obtained from www.physiomed.com use the PALS electrodes if you live in the USA you should be able to get the tyco electrodes {i have just started using them as i have found them to be the best for my sensitive skin} but they cost a lot of money.if you want any more information regarding advice on TENS please feel free to contact me .tony.beer1@goolemail.com
    i hope that this has been useful to you you will find by playing around with electrode placement that you will find the sweet spot that may be slightly different from where i have suggested .dont worry if you arnt getting any relief from your unit at first because TENS is a funny thing for some folk it works at the very first attempt and for other nothing ..i myself use my acticare from 3am in the morning until i got to bed and sometimes all night depending on my level of pain.there is another trick that you wont find in any TENS instruction book its for sciatica first put one electrode just to the right of you lower back{if you have right leg pain or left if your leg pain is on the other side] then place the other electrode on the inside of you right ankle near the bit that sticks out {again you may have to play around with placement to get the maximum effect .then use the tap tap tap mode on you unit you will find that you will feel the TENS more at you ankle rather than you lower back but trust me it works ..as i have said TENS placement is not an exact science it all depends on your body but with a little placement you will attain good results
  • i have been emailed recently about tens and piercing and can i use my TENS with various piercings .well the answer is yes and long as the electrode dont come in to contact with the metal as you could get burnt .also dont use electrodes across the chest area or across the temples and never on the genitals i hope that this has answered you question to the person the asked me

  • I've been using the tens since they were these huge pieces of things in the rehab centers where I used to go for physical therapy.Never thought then that I'd see the day when we could just strap them on and walk around with them..let alone bring them home.

    I've found that it takes practice with the leads and placement..and you might get frustrated too because even when you do find the 'perfect' areas for the leads--your pain can change just slightly,and you are peeling and slapping those on all over the place again.

    So..just like everything else,TENs takes patience.
    Never place the electrodes on your head or chest,near your heart.I sometimes want to put them on my temples on low,whenever I get a headache it feels good to massage that area-so I wonder if the TENs would feel good on low-but I won't do it because the DR and the book both said not to.Wouldn't want to mess with those brain cells now would we...lol.

    Good luck with yours-I hope it works for you,and I'm glad I saw this when I logged on b/c it reminded me that it's time to reorder new pads for my TENs.
  • Like Straker, I also love my TENS. My unit has two channels and I can change the intensity of either independently. When I place the pads I surround the pain area and set up the channels in an X pattern. It seems more effective than up/down or side to side. It does seem to take some practice to place the pads and it may take a while to find the right placement. Just experiment around a bit, if it doesn't seem to be working then move the pads a little and try again!
  • My dr. actually had my PT order my Tens unit for me. When it came in PT helped me adjust the electrodes and settings comparable to the Tens unit I had used in PT. As time goes on you just experiment and learn to adjust it each day.

    Do NOT ever forget and move a pad while the unit is running! One day I was busy and not thinking about it I just reached down to move the pad to a better location. Well, that thing stuck to my hand and I couldn't get my bearings fast enough to turn the darn thing off! I was shrieking and my husband came running in to see what was wrong...LOL...I learned my lesson!

    I hope your Tens unit works for you!
  • So, how long is it acceptable to leave one on? What I've read typically recommended durations of 15-20 minutes at a time. Is there a reason for this limit? Is it the most effective time frame, or is it harmful to have it on for longer?

    Also, after an injection treatment (a rather unsuccessful one by a rather obnoxious specialist I won't be seeing again), I have a tender spot at the site which has been sore to pressure for over a week now. When using the TENS in the area of the spot, it was painful for several minutes (10 or so). Then the pain started to go away. I wonder if I should avoid it or if the fact that the pain lessened with the TENS unit is a good thing.

    I hope the injection didn't cause a problem and damage a nerve or something. I'll probably call my doctor tomorrow about it...

  • your tens on for as long as you like most instructions tell you to use it for 20 mins 3 times a week .but some tens like mine have a facility to turn the time off so you can use it until the batteries run out .i use mine almost continuously {with doctors and pain consultants ok } you wont get ill from using a tens you may find that the area where you have the electrodes can get a bit sore if this happens use sensitive electrodes like PALS blue or tyco blue .but if your skin is broken dont use until it has healed .i use mine a lot because i find with out it my pain is too much for me even with pain killers .TENS works well for some but for others it is useless .if you find it works for you then use it as much as you like as i have said before you may have to play around with electrode placement to find the sweet spot for your problem .
  • My Dr/s both told me that I could use my TENs all day long,but not to sleep with it on.I think the whole not sleeping w/it is a safety issue really,and wouldn't really hurt at all..because I stay in the same position all night long.Well,I only sleep 3-4 hrs at a time,but I wake up in the exact position that I get comfortable in.I would know if I had to change positions because it's painful.So,no safety issue there with the wires..

    Ask your Dr or PT about the time for you.I can only tell you what my Drs.told me,but I don't know your medical conditions--it's always best to ask your Dr.,even with our experiences here.
  • My doctor simply said to use it "as needed". There's no timer on my unit, so it stays on as long as I want. I've been trying different durations to see how it works. I also had a couple other questions about using the TENS; just some minor information questions.

    1. About how long will a single 9-volt battery last?

    2. Even with pain meds, the pain comes back not long after stopping my TENS unit. Is that typical, or will the treatment benefit tend to last longer the more I use it?

    So far, I seem to need it on at least 30 minutes to get good pain relief. I think I found the right placement, making a square around the area of my pain (with the electrode pairs placed diagonally). Will placing them further apart decrease their effectiveness, or does it normally help? At the moment they're placed with about a half inch between the electrode tabs.

    I also want to say a big THANK YOU to everyone who's offered their input and advice. You've been very helpful, and I don't think I would have made as much progress with my current treatment without your help.

  • I was told that interferential electromuscle stimulation is the most theraputic. Jay described it above... If you Google it, you'll find a lot of great stuff. You can also combine your stil treatments with an ice pack or hot moist pack, just make sure not to burn or freezer burn yourself! I hope you like the stim and I hope it helps you a lot! :)

    Much love,
  • My TENS rep said to run it for an hour and then shut it off for a while, the effects should continue. They didn't for me, as soon as I shut it off any effects go away immediately. So I run it all day. My rep says that I may find that I'll develop a "dependence" and have to slowly crank up the volume, so to speak. I haven't had that problem yet and I run it every day since October.
  • i am still in pain when using it but it helps without it you can notice the pain more .as soon as the unit is turned off the pain is more noticeable {as it happen i have just come down from my bed after being in it for only one hour i took the acticare off just before i went to be and i have just put it on again and had some more pain killers } the acticare when set on TSE mode is supposed to be accumulative ..but i have not found this to be the case .even tho i swear by TENS i still think that if your pain is very bad the TENS just acts as a distraction .when i ran out of pain killers over the weekend i had both my acticares on and to honest it made no difference what so ever.i do believe that i have very bad pain compared to what some have said they can do i only know just how ill my pain makes me feel .i went out to day shopping to ASDA {walmart} and could only walk for 15 mins before returning to the car with evil back pain .my mum also has a TENS for mild pain and she finds it works well but she only take 8/500 type pain killers
    .she is 70 and in less pain than me mind you she has not had 2 major back operations and does not have congenital spinal abnormalities and a back full of scar tissue!
  • straker, I agree with you 100% and am pretty much in the same boat. Plus, I like the feel of the stimulation. :)
  • Oh, how I miss my TENs, they took it back after only a few weeks. =((

    I put mine in a square starting to the sides of the top of my "crack" and then above that. However, I think I may have overdone it, because I started to get numbness across the back through these locations...
  • I do a square around the pain - so the pads are 5" apart on the top and 4" apart on the bottom. There are warnings not to use TENS when sleeping or driving. I would like to add another warning, now I have a cheaper unit since my insurance won't cover, but in the summer if I start to sweat I will get shocked.
  • justauntbjjustauntb Posts: 1
    edited 12/20/2014 - 8:02 AM
    I just got mine a few days ago and it is helping a lot with my lower back pain and shoulder pain...but, now I am having pain in the VERY low back and in my behind. I am thinking Sciatica. My doctor said that my pain is coming from my powerchair which I am in except for sleeping. The constant bouncing in the chair, especially if I am outside, gives me back pain all the time.
    I am 74 yrs old and can NOT have surgery of any kind because of my heart condition and COPD....so, I am stuck with drugs or other pain relief. I refuse to take drugs as I was addicted to Vicadan and it took a month before I felt like a human being.
    With that said, I guess I am down to the tens unit as my only source of reliIf.
    I have had a problem with the TENS at my very lower back making it hurt worse after I take it off. The only time it doesn't hurt is when I am in bed with various props around me and a pillow between my legs....but, I can't live in bed the rest of my life. LOL
    Any suggestions?
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